When should sleep apnoea be suspected?
For many sleep apnoea patients their spouses are the first ones to suspect that something is wrong usually from their heavy snoring and apparent struggle to breathe. Co-workers or friends of the sleep apnoea victim may notice that the individual falls asleep during the day at inappropriate times (such as while driving a car, working or talking.11 The patient also complains of being tired in the morning. The patient often does not know he or she has a problem and may not believe it when told. It is important that a person sees a doctor for evaluation of the sleep problem. On physical examination most patients with OSA are overweight typically have short thick necks, in fact a neck circumference more than 17 inches in a man correlates with increased risk of this disorder.12 Facial abnormalities may be recognized in patients of OSA. These include small receding chin, small mandible, a large tongue, receding jaw with 2 mm or more of lower lip protrusion may be an obvious finding in some pa
